Even India’s richest states are becoming less liveable

Prime minister Narendra Modi wants a “new India” built by 2022. “By then the poor shall have concrete houses, the farmer shall double his income, youths and women will get ample opportunities, and India [will be] free of casteism, terrorism, corruption,” he said during his Independence Day speech on August 15.

Let’s set aside the second part of Modi’s vision. There is no chance casteism or corruption will be gone by 2022, and, given the exclusivist, majoritarian impulses of the Bharatiya Janata Party, and its extended Hindu family, terrorism is likely to grow stronger.

It does, however, make sense to explore the economic progress that Modi envisions. Some of this future is already evident in India’s smaller, richer states. Let us consider Uttar Pradesh and Goa, which is also representative of a select group of states as—or nearly as—advanced as it is. For a bunch of related prosperity indicators, these include Kerala, Puducherry, Nagaland, Sikkim, Mizoram and, to some extent, Tamil Nadu. Uttar Pradesh represents, in general, the vast, underprivileged Indian majority living in the northern states of Rajasthan, Madhya Pradesh, Chhattisgarh, Bihar and Jharkhand and the eastern states of West Bengal, Odisha and Assam.

At first glance, Uttar Pradesh and Goa appear hard to compare. One is a decrepit state, home to 204 million people; the other is a relatively shiny state of 1.8 million. We compare them because they occupy extreme ends of the reality that is India.

The primary yardstick I have used to identify the opposite ends of India’s realities is the infant mortality rate, or the number of deaths per 1,000 live births. There are, of course, other indicators that we shall consider, but the health of babies is always a good place to start.

Goa’s healthy babies

The infant mortality rate is a reasonable indicator of an economy’s health–not always its wealth—its administrative capacity, and its basic humanity. Here is how the life cycle of a low infant mortality rate plays out: if fewer babies die, people tend to have fewer babies, allowing girls to have a better chance at life, education and healthcare; if girls are better educated and healthier, they are more likely to work and contribute to economic growth, and have fewer babies; if fewer babies are born in an under-developed country, it is likely they will get more nutrition and grow up to be smarter and more productive, boosting their country’s productivity and well-being.

Goa’s infant mortality rate, at 9, is India’s lowest. That of Uttar Pradesh, at 46, is India’s third worst (Madhya Pradesh is the worst at 50, Assam next at 47, and Odisha the same as Uttar Pradesh), according to a December 2016 census bulletin, the latest available data. Goa’s infant mortality rate is one better than the combined figure for Europe and Central Asia, where people tend to be richer than Goans. Uttar Pradesh’s is worse than conflict-ridden Yemen (34) and the same as bankrupt Zimbabwe.

A selection of other indicators from the latest national health data reveals exactly how backward Uttar Pradesh is in providing a conducive atmosphere for children:

In short, Goa provides its children with greatly better healthcare and offers a more conducive home environment with clean air, water and toilets than Uttar Pradesh (and most states). It is particularly striking that many indicators are better in rural Goa than in its urban areas: more women are literate, and fewer marry before the legal age. In Uttar Pradesh, the opposite is true.

So, should Goa be what the rest of India aspires to, especially vast swathes of the north that I mentioned?

Here is where it gets tricky.

UP behind, but improving

Actually, Uttar Pradesh is far better off than it used to be on almost every parameter a decade ago. In 2005, the state’s infant mortality rate was 76, so the fall to 46 has been substantial. Goa, in contrast, fell from 16 to 9, and progress appears slow. While Goa remains one of India’s best places to live and raise a child, its prosperity and well-being reveal some disquieting trends.

First, consider Goa’s sex ratio. The good news, as the overall sex ratio indicates, is that Goa has more women than men, similar to a handful of states, including Kerala and Tamil Nadu. The bad news: this is changing. The sex ratio at birth, which indicates the situation in the last five years, reveals that fewer girls are now being born than boys (in Kerala, Goa’s close competitor for the top spot, on many development indicators, this is not the case). While sex ratios have generally improved over 10 years to 2015 in Goa—where, as the date indicates, emancipation appears to have strong roots—urban Goa is following the path of prosperous, urban areas elsewhere in India. Urban south Goa’s sex ratio is now among India’s worst at 792 females per 1,000 males, as this IndiaSpendanalysis notes. Rural south Goa’s sex ratio, in contrast, is among India’s best at 1,409.

Second, while Goan children are, in general, well cared for, the health data also reveals that the proportion of children under five who were wasted—which means, low weight for height—in urban Goa doubled over 10 years to 2015 while in rural Goa, the proportion of wasted children fell to 12% from 17% over the same period. The proportion of wasted children in urban south Goa is now five times more than in rural North Goa. Overall, Goa witnessed a 57 percentage-point rise in wasting between 2005 and 2015. Rhea Colaco, who wrote the IndiaSpend analysis I referred to earlier, calls this “the burden of prosperity.” A rise in wasted children accompanies a rise in adult obesity. For instance, 33% of women in south Goa are obese, the same proportion as wasted children in the area.

This data implies that Goa, which once set health trends, is showing signs of adopting the worst practices prevalent in the India beyond its borders. To be sure, this does not mean that every state follows the trends set by rich Goa and poor Uttar Pradesh. There are outliers in every population and data set. For instance, 28% of women in poor, conflict-wracked Manipur may be injecting drug users, according to this 2015 United Nations study, and the state—with almost double the population of Goa—may be home to 34 insurgent groups, but it has the same infant mortality rate as Goa. At the other end of the economic spectrum is rich Gujarat, whose relative prosperity hides some of India’s worst social development indicators. For instance, 34% of Gujarati women aged 15 to 49 are underweight; only Jharkhand (35%) does worse.

But these, as I said, are outliers, and it is safe to say India’s rich and poor states are likely to follow trends in Goa and Uttar Pradesh, respectively. Like Goa, Kerala, too, reports a rise in obesity and its linked ills, such as hypertension, diabetes and high blood pressure, precursors to cardiovascular disease, which is rising not only in the more urbanised parts of poor states but also in rural areas. The base of individual prosperity may be smaller in states such as Uttar Pradesh, and social indicators may still be unsatisfactory, but it is clear that people are becoming richer and healthier. Indeed, the signs of a downslide in Goa are matched by a steady uptick in Uttar Pradesh.

Rise and fall

However haphazardly this may be playing out, India is undergoing a great levelling, with inequality accompanying the general rise in prosperity. This is equally true for economic and governance indicators, as it is for the social indicators we discussed. More cities are rising, and more Indians are flocking to them, although these cities, whether in Uttar Pradesh or Goa, are becoming more unliveable than before. The worst characteristics of the poorest, most poorly administered states are percolating down to the richest states, where administrative capabilities have noticeably deteriorated.

That is certainly true of Goa, once known for its crime- and corruption-free life and lush landscape, now ravaged by mining and construction. From crime to illegal construction to political patronage of criminal activity, the state shows distinct signs of having borrowed the worst ideas from states such as Uttar Pradesh. The extent of corruption in Goa was revealed in 2015 when the government declared the coconut palm was no longer considered a tree, which meant that builders would no longer need permission to cut it down, hastening Goa’s haphazard concretisation. That decision was rescinded after two years and great damage, but the larger point is clear: whether in health or governance, Goa is sliding, and Uttar Pradesh is improving. India’s future appears to lie somewhere in between.